Respiratory Disorders in VS .NET

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Respiratory Disorders
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scientist was decapitated (deh-CAP-ih-tay-ted) during the Reign of Terror of the French Revolution Poor Antoine had his head (capit) cut off (de-) by the dreaded guillotine (GIL-uh-teen)! The Republic has no need of geniuses! the judge cruelly declared when an appeal was made to save Lavoisier s life There is a strange legend that Lavoisier arranged a nal experiment at his death He supposedly told an assistant to count the number of times that he blinked after he had his head cut off! (The legend says he blinked 15 to 20 times, but this is very doubtful!)
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Medical Case History: An Emergency Tracheotomy to Treat Airway Obstruction
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We have talked about the importance of inhaling adequate oxygen during inspiration and of the grave dangers we face during tissue hypoxia If hypoventilation tends to result in hypoxia, then apnea (AP-nee-ah) total lack (a-) of breathing (pnea) is even worse! If a state of apnea lasts for just a few minutes, a condition of (-ia) severe tissue anoxia (an-AHK-see-ah) results This is a complete lack (an-) of tissue oxygen (ox) Loss of consciousness and irreversible brain damage are the terrible consequences of this deadly duo (apnea leading to anoxia)! In the present clinical case, George B was gulping down big pieces of steak during a business lunch He had a few drinks, and he was busy talking and laughing with a customer while he ate The clinical problem George suffered involved his epiglottis a small ap of cartilage that forms a lid upon (epi-) the glottis (GLAHT-is) (see Figure 98, A, and review Figure 92) The glottis is a small tongue (glott) -shaped opening between the vocal cords of the larynx Normally, when a person swallows a food bolus (BOH-lus), it s just a small, soft ball (bol ) of food that is present (-us) After the person ips the bolus back into the pharynx, the bolus falls down and pushes the epiglottis shut from above (Figure 98, B) This small ap closes snugly over the top of the glottis Such closure prevents pathologic (path-oh-LAJ-ik) respiratory aspiration (as-pih-RAY-shun) This is the potentially deadly breathing in (aspir) of food, liquid, or other foreign objects into the larynx and airways Under normal conditions, the food bolus just slides down into the esophagus, and nally enters the stomach But George B just wasn t paying attention He was doing too much laughing and talking while he bolted down huge chunks of partially chewed steak Suddenly, a big piece of steak became wedged in between the epiglottis and the glottis, thereby completely occluding the opening into his larynx! (Study Figure 98, C) Almost immediately, poor George made the Heimlich (HIGHM-lik) sign, also called the universal choking signal (This sign was rst described by
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Epiglottis open
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Pharynx Esophagus (leads to stomach) (A)
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Glottis Larynx
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Food bolus
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Epiglottis closes
Food bolus gets stuck here
Fig 98 Normal versus abnormal closing of the epiglottis (A) Anatomic position of
epiglottis as a lid upon the glottis (tongue-shaped opening in top of larynx) (B) Normally, a small food bolus pushes the epiglottis shut during swallowing (C) During choking, a large bolus (chunk of steak) gets wedged between the epiglottis and the glottis, occluding the larynx
H J Heimlich, an American physician who was born in 1920) Speci cally, George grabbed his throat with his thumb and index nger, indicating that he was choking and couldn t speak A waitress in the restaurant, seeing that poor George was very distressed, came up behind him and performed the Heimlich maneuver (Figure 99, A) During the Heimlich maneuver, the choking person is grasped from behind, with the rescuer pressing one st into the substernal (sub-STER-nal) area of the victim s thorax (chest) The rescuer places her other hand rmly over her st The rescuer then pulls her st rmly and sharply into the epigastric (ep-ih-GAS-trik) region of the thorax As the phrase indicates, this is the region lying upon (epi-) the stomach (gastr) The pressing st greatly increases the intra-abdominal (in-trah-ahb-DAHM-ih-nal) pressure The greater pressure forces the wedged-in food bolus out of the choking person s larynx If successful in dislodging the food bolus, the Heimlich maneuver prevents death by asphyxiation (as- k-see-AY-shun) Asphyxiation exactly means the process of (-tion) stopping the pulse (asphyx) In this instance, most unfortunately, the Heimlich maneuver was unsuccessful A physician sitting at another table suddenly rose to his feet and offered
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